微创股骨近端防旋髓内钉对骨质疏松性股骨粗隆间骨折患者的治疗效果分析

Effect Analysis of Minimally Invasive Proximal Femoral AntiRotation Intramedullary Nail on Patients with Osteoporotic Intertrochanteric Fracture of the Femur

目的分析微创股骨近端防旋髓内钉对骨质疏松性股骨粗隆间骨折患者的治疗效果。方法选取2016年5月至2022年5月通许第一医院收治的82例骨质疏松性股骨粗隆间骨折患者展开研究,并以随机抽样法为分组依据,将其分为对照组(N=41)及试验组(N=41),对照组行近端锁钉接骨板治疗,试验组行微创股骨近端防旋髓内钉(PFNA)治疗,对比两组围手术期相关指标、并发症发生情况、术后疼痛程度评分及手术前后髋关节功能评分(Harris)波动情况。结果试验组手术时间、住院时间、术后首次负重站立时间比对照组更短,术中出血量比对照组更低,差异有统计学意义(P<0.05)。试验组并发症发生率(2.44%)低于对照组(14.63%),差异有统计学意义(P<0.05)。两组术后1 d疼痛程度评分对比,差异无统计学意义(P>0.05),术后3 d、术后5 d、术后10 d试验组疼痛程度评分均低于对照组,差异有统计学意义(P<0.05)。术前两组Harris评分对比,差异无统计学意义(P>0.05),术后1个月、术后2个月、术后3个月试验组评分高于对照组,差异有统计学意义(P<0.05)。结论微创股骨近端防旋髓内钉具有极强的滑动、抗旋转、锚合力及支撑作用,能充分契合骨质疏松性股骨粗隆间骨折治疗,具有临床应用价值。

Objective To analyze the therapeutic effect of minimally invasive proximal femoral anti-rotation intramedullary nails on patients with osteoporotic intertrochanteric fracture of the femur.Methods A total of 82 patients with osteoporotic intertrochanteric fracture of the femur admitted to Tongxu First Hospital from May 2016 to May 2022 were selected for this study.Based on random sampling,they were divided into a control group(N=41)and an experimental group(N=41).The control group received proximal locking plate treatment.The experimental group received minimally invasive proximal femoral antirotation intramedullary nail(PFNA)treatment.The perioperative relevant indicators,complications,postoperative pain degree score,and hip function score(Harris)fluctuation before and after surgery were compared between the two groups.Results The operation time,hospital stay,and first weight-bearing standing time of the experimental group were shorter than the control group,and the intraoperative blood loss was lower than the control group,the difference was statistically significant(P<0.05).The complication rate of the experimental group(2.44%)was lower than that of the control group(14.63%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in pain degree score 1 day after surgery between the two groups(P>0.05),and the pain degree score of the experimental group was lower than that of the control group 3,5,and 10 days after surgery,the difference was statistically significant(P<0.05).There was no significant difference in Harris score between the two groups before surgery(P>0.05),but the test group scored higher than the control group in the 1st,2nd,and 3rd month after surgery,and the difference was statistically significant(P<0.05).Conclusion Minimally invasive proximal femoral anti-rotation intramedullary nail has strong sliding,anti-rotation,anchor-force,and support functions,which can fully fit the treatment of osteoporotic intertrochanteric fracture of the femur,and has clinical application value.